Adapting an evidenced-based intervention to reduce IPV for use among young heterosexual couples in South Africa

暴力侵害妇女行为在全球范围内很常见，估计有三分之一的妇女在其一生中经历过这种情况。在我们以前的工作中，我们发现生活在城市非正规住区的年轻妇女（18-30岁）的比例甚至更高，大约三分之二的人在过去一年中经历过身体和/或性IPV。虽然有越来越多的干预措施寻求减少暴力侵害妇女行为，但其中很少有成功的城市非正规住区的年轻妇女。在这个项目中，我们寻求采取一种有效的干预措施-“垫脚石”和“创造未来”-并通过向异性恋夫妇提供这种干预措施来加强这种干预措施，使之更加有效。在之前的一项研究中，我们表明，垫脚石和创造未来可以减少男性的IPV犯罪。其他研究表明，与夫妇合作，而不是与“个别”人合作，可以加强干预效果。我们之前的定性研究支持这一点，一些男性描述了他们如何在垫脚石和创造未来中与女性伴侣（而不是在干预中）合作以改善结果。我们刚刚完成的另一个项目关注的是处于类似情况下的年轻女性，发现她们认为以夫妻为中心的干预对她们有益。在这个项目中，我们将改编《垫脚石》和《创造未来》，用于生活在南非德班城市非正式住区的年轻（18-30岁）异性恋夫妇。我们将首先与年轻人和当地利益相关者进行定性研究，以了解年轻人之间的关系动态。然后，我们将调整垫脚石和创造未来的变化理论，课程和实施手册，用于年轻夫妇，在这一过程中广泛与年轻人接触。在整个工作过程中，一个中心重点将是确保妇女在该项目以及经修订的干预课程和执行手册中的安全。我们将进行更多的访谈和研讨会来确保这一点。我们最终将在社区招募100对夫妇进行适应性干预试验。我们将重点关注干预的可接受性、可行性和安全性，并在6个月时进行随访。次要结果将是评估干预的潜在效应大小。如果干预是有希望的，我们将编写一个后续试验的协议，以比较夫妇干预与原始干预。为了确保青年人的有意义参与，我们将从项目一开始就设立一个青年人咨询小组，由10名青年人（5名妇女，5名男子）组成，他们的背景与我们所针对的社区相似。这个小组将定期开会，我们将与他们讨论项目，测试会议和接收反馈，在我们通过他们的参与塑造项目。

Violence against women is common globally, with an estimate one-third of women experiencing this in their lifetime. In our previous work we have found that young (ages 18-30 years) women living in urban informal settlements experience even higher rates, with around two-thirds experiencing physical and/or sexual IPV in the past year. While there are a growing number of interventions that seek to reduce violence against women, very few of them are successful for young women in urban informal settlements. In this project we seek to take one effective intervention - Stepping Stones and Creating Futures - and strengthen it to make it more effective, through delivering it to heterosexual couples. In a prior study we showed that Stepping Stones and Creating Futures could reduce men's perpetration of IPV. Other studies have shown that working with couples, rather than 'individual' people can strengthen intervention outcomes. Our prior qualitative work supports this, with some men describing how in Stepping Stones and Creating Futures they worked with their female partner (not in the intervention) to improve outcomes. Another project we have just completed, which focused on young women in similar contexts, found that they thought a couples focused intervention would be beneficial for them.In this project we will adapt Stepping Stones and Creating Futures for use with young (18-30) heterosexual couples living in urban informal settlements in Durban, South Africa. We will first undertake qualitative research with young people and local stakeholders to understand relationship dynamics, among young people. We will then adapt the Stepping Stones and Creating Futures theory of change, curriculum and implementation manuals for use with young couples, engaging extensively with young people in this process. Throughout this work a central focus will be on ensuring women's safety in the project and in the revised intervention curriculum and implementation manuals. And we will undertake additional interviews and workshops to ensure this.We will finally pilot the adapted intervention with 100 couples recruited through communities. We will focus on the acceptability, feasibility and safety of the intervention, with follow-up at 6 months. A secondary outcome will be to assess potential effects sizes of the intervention. If the intervention is promising we will write a protocol for a follow up trial to compare the couples intervention with the original intervention. To ensure young people's meaningful engagement we will establish from the beginning of the project a Young People's Advisory Group, comprising of 10 young people (5 women, 5 men) from similar backgrounds to the communities we are targeting. This group will meet regularly and we will discuss the project with them, test sessions and receive feedback, shaping the project as we go through their engagement.